YOUNG ARTIST AUDITION FORM

NAME_________________________________________________________

PERMANENT ADDRESS__________________________________________

CITY/STATE/ZIP________________________________________________

CURRENT ADDRESS____________________________________ GRADE LEVEL_______________

CITY/STATE/ZIP_______________________________________ AGE_________ (23 years of age and younger)

TELEPHONE - PERMANENT_______________________________ BIRTH DATE____/_____/_____

TELEPHONE - CURRENT __________________________ E-MAIL ADDRESS___________________________

INSTRUMENT OR VOICE CLASSIFICATION______________________________________________________

YEARS OF EXPERIENCE______  INSTRUCTOR'S NAME____________________________________________

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TITLE OF COMPOSITION_____________________________________________________________________

COMPOSER___________________________________ MOVEMENT___________________________________

OPUS____________________________________________ PERFORMANCE TIME_______________________

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MUSIC MUST BE IN PRINT AND AVAILABLE SIX WEEKS BEFORE THE CONCERT. APPLICATIONS WILL
NOT BE ACCEPTED OR CONSIDERED WITHOUT THIS SECTION COMPLETED.

PUBLISHER__________________________________________________________________________________

PUBLISHER ADDRESS_________________________________________________________________________

PUBLISHER PHONE NO._____________________PURCHASE PRICE____________ RENTAL FEE___________

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PARENTS' NAME _____________________________________________________________________________

HOMETOWN NEWSPAPER_____________________________________________________________________

COLLEGE NEWSPAPER________________________________________________________________________

PLEASE RETURN TO: Fort Dodge Area Symphony                     THIS FORM MUST BE POSTMARKED
                                      P.O. Box 1291,                                                           WITH ENTRY FEE
                                      Fort Dodge, Iowa 50501                    NO LATER THAN MONDAY, DECEMBER 12, 2011
                                                                                                               $15 ENTRY FEE (non-refundable)

NOTE: Phone, Fax, or E-Mail applications without payment will not be considered.

 General Schedule: Morning - High School Soloists; Afternoon - College Soloists. If you have a conflict that requires a
special time, or have any questions, please contact: Ardella Hein 515-573-4224, or e-mail FDASYA@gmail.com.

Auditions to be held Saturday, January 21, 2012, (Snow Date January 28, 2012) at
Phillips Middle School, 1015 5th Ave. North, Fort Dodge, Iowa 50501
Concert Date: Sunday, April 22, 2012 - 3:00 PM

          This form may be photocopied as necessary